Provider Demographics
NPI:1437518784
Name:SOLUTIONS FOR SUCCESS, LLC
Entity Type:Organization
Organization Name:SOLUTIONS FOR SUCCESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:D
Authorized Official - Last Name:WENDORF
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:262-719-0676
Mailing Address - Street 1:N19W24400 RIVERWOOD DR # 350
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1166
Mailing Address - Country:US
Mailing Address - Phone:262-719-0676
Mailing Address - Fax:
Practice Address - Street 1:N19W24400 RIVERWOOD DR # 350
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1166
Practice Address - Country:US
Practice Address - Phone:262-719-0676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-15
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2977-57251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health